Monthly multi disciplinary team clinic run by a specialist physiotherapist and consultant rheumatologist, with patients seen by both. All patients are seen in the clinic once every 1-2 years depending upon disease severity. Those needing to be seen between times are seen in Dr K Mackay’s rheumatology clinic or have access to the specialist nurse clinic and nurse telephone clinic, they can see specialist physiotherapist between times as well. Spondyloarthritis group clinics are held three times a year (Dr K Mackay and specialist nurse; specialist physiotherapist attends on occasions). These group clinics are in the evenings for those who work. Many patients on biologics attend these. The aim of the group spondyloarthritis clinic is both patient review and education. There are two specialist spondyloarthritis physiotherapists; one based in Torbay hospital and the second in Newton Abbot hospital. Hydrotherapy is available in Torbay hospital, an exercise rehabilitation group is based in Newton Abbot Hospital and a fatigue group at Torbay.

Rheumatologists with an interest in AS are Dr Kirsten Mackay.

There is an excellent rheumatology database, including a spondyloarthritis database and careful records of measures such as BASDAI are kept for every visit. This means the department has very good record keeping. The data gathered is used extensively in the context of the rheumatology helpline and rheumatology teleclinics. The vast majority of AS patients are seen in the AS clinic by Dr Mackay and the specialist multi disciplinary team. There is access to the full range of biologic therapies, and the department has extremely good relationships with gastroenterology, dermatology and ophthalmology for shared care. The department has started a series of patient education conferences, in addition to four monthly group clinics for review and education. There is access to a joint clinic with a foot and ankle surgeon; a virtual clinic with a dermatologist; and a joint clinic with an upper limb surgeon.